Coordination of Benefits Recovery Analyst

Published
July 19, 2021
Location
Atlanta, GA
Category
Job Type

Description

Imagine a workplace that encourages you to interpret, innovate and inspire. Our employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and inspire positive change. You can be part of an established company with a 40-year legacy that helps our customers thrive by interpreting our client's needs and tailoring innovative healthcare cost management solutions.

Our commitment to diversity, inclusion and belonging are part of the fabric of our company. We strive to create a workplace that fosters mutual respect and collaboration, where every talent individual can participate and perform their best work. We are MultiPlan and we are where bright people come to shine!

This role secures and evaluates health insurance and employment information to determine the correct order of claim payments for our clients. In addition, the analyst identifies claim overpayments, conducts outreach to providers to secure recovery of incorrectly paid claims, and accurately documents findings and refunds for client billing and reporting.
JOB ROLES AND RESPONSIBILITIES:
1. Selects from a list of predetermined cases, gather all related health insurance information and determine order of benefits based on guidelines and policy and procedures
2. Analyzes claims based on DOS, covered benefits and other related information to select claims with potential for refund/recovery
3. Contacts providers to inform them of claim overpayment, carrier re-bill information, and refund procedures according to client-specific requirements and in compliance with state and federal laws
4. Prioritizes casework based on aging, timely filing rules and recovery potential. Conduct follow-up with providers over the phone or in writing as needed to secure refunds for clients.
5. Documents all contacts through recovery or exhaustion of recovery effort.
6. Responds to and resolve any client issues related to COB findings
7. Complies with HIPAA regulations, as well as Security, Policies, and Procedures
8. Collaborate, coordinate, and communicate across disciplines and departments.
9. Ensure compliance with HIPAA regulations and requirements.
10. Demonstrate Company's Core Competencies and values held within.
11. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role.
12. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
JOB SCOPE:
This role works in a self efficient detail oriented manner. The successful incumbent is an individual who uses creative problem solving skills to review and update member information. They must have the desire to deliver high quality results to our clients. Must be open to feedback,teamwork and show interest in contributing ideas to improve our processes. A recovery Analyst must be able to adapt to changes and retain new information quickly.

Note: This job cannot be performed in Colorado.

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